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种族/民族、地区和城乡之间接受糖尿病教育的差异。

Racial/ethnic, regional, and rural/urban differences in receipt of diabetes education.

机构信息

Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina (Ms Brown-Guion, Ms Hernandez-Tejada, Dr Dismuke, Dr Egede)

Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H. Johnson VA Medical Center, Charleston, South Carolina (Ms Youngerman, Dr Egede, Dr Dismuke)

出版信息

Diabetes Educ. 2013 May-Jun;39(3):327-34. doi: 10.1177/0145721713480002. Epub 2013 Mar 12.

Abstract

PURPOSE

The objective of this study is to examine the differences in receipt of diabetes education according to risk factors that are associated with the disease, including race/ ethnicity, region, and rural/urban location.

METHODS

National data from the 2007 Medical Expenditure Panel Survey (MEPS) were analyzed to examine likelihood of receipt of diabetes education in terms of race, urban/rural location, and region.

RESULTS

Of 1747 adults with type 2 diabetes, 65.6% were white, 15% black, and 19.4% other. In addition, 49.3% were male, 50.6% female; 46.9% were under age 64; 39.8% had more than high school; 34.1% were from low-income households, 35.1% middle income, and 30.8% high income; 39.5% lived in the South while other regions were equally represented; 80.6% lived in rural areas; 63.7% did not receive any type 2 diabetes education. Patients in the South were least likely to receive education (67.5% did not). Logistic regression demonstrated that being black (odds ratio [OR] = 1.38, 95% confidence interval [CI], 1.03-1.84) and living in an urban area (OR = 1.40, 95% CI, 1.00-1.97) were associated with a higher likelihood of receiving diabetes education. By contrast, being 65 or older was associated with lower probability of receiving education (OR = 0.59, 95% CI, 0.40-0.87), as was lack of insurance (OR = 0.54, 95% CI, 0.33-0.88) CONCLUSIONS: Being black independently increased likelihood of receiving diabetes education, but living in rural areas, being uninsured, and living in the South reduced chances one would receive this helpful information. Therefore, further research should examine benefits of leveraging technology such as telemedicine to improve delivery of diabetes education to those living in rural areas.

摘要

目的

本研究旨在探讨与疾病相关的风险因素(包括种族/民族、地区和城乡位置)对糖尿病教育接受程度的差异。

方法

分析 2007 年医疗支出面板调查(MEPS)的全国数据,以检查种族、城乡位置和地区对糖尿病教育接受程度的影响。

结果

在 1747 名 2 型糖尿病患者中,65.6%为白人,15%为黑人,19.4%为其他种族。此外,49.3%为男性,50.6%为女性;46.9%年龄在 64 岁以下;39.8%受过高中以上教育;34.1%来自低收入家庭,35.1%为中等收入家庭,30.8%为高收入家庭;39.5%居住在南方,而其他地区的分布则较为平均;80.6%居住在农村地区;63.7%未接受任何 2 型糖尿病教育。南方地区的患者接受教育的可能性最小(67.5%未接受)。Logistic 回归分析表明,黑人(比值比[OR] = 1.38,95%置信区间[CI],1.03-1.84)和居住在城市地区(OR = 1.40,95% CI,1.00-1.97)与接受糖尿病教育的可能性更高相关。相比之下,65 岁或以上与接受教育的可能性较低(OR = 0.59,95% CI,0.40-0.87)相关,而没有保险(OR = 0.54,95% CI,0.33-0.88)也是如此。

结论

黑人独立增加了接受糖尿病教育的可能性,但居住在农村地区、没有保险和居住在南方地区会降低接受这种有益信息的机会。因此,应进一步研究利用远程医疗等技术优势为农村地区提供糖尿病教育的益处。

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